FDA Adverse Event Malfunction Summary report: N

DREAMSTATION AUTO CPAP

MDR report key: 15429961 · Received September 15, 2022

Report

Report Number
2518422-2022-81243
Event Type
Malfunction
Date Received
September 15, 2022
Date of Event
November 12, 2021
Report Date
October 25, 2023
Manufacturer
RESPIRONICS, INC
Product Code
BZD
PMA / PMN Number
K131982
Removal / Correction Number
RES 88058
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE MANUFACTURER WAS CONTACTED IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE/RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. THE MANUFACTURER PREVIOUSLY RECEIVED INFORMATION ALLEGING COUGH RELATED TO A CPAP DEVICE'S SOUND ABATEMENT FOAM. THERE WAS NO REPORT OF PATIENT HARM OR INJURY. THE PATIENT RECEIVED MEDICAL INTERVENTION. REPEATED ATTEMPTS TO HAVE THE DEVICE AND COMPONENTS RETURNED FOR EVALUATION AND INVESTIGATION WERE UNSUCCESSFUL. THE MANUFACTURER BELIEVES THEY WILL BE UNABLE TO GATHER ADDITIONAL INFORMATION. THE MANUFACTURER IS SUBMITTING A FINAL REPORT AT THIS TIME. IF PERTINENT INFORMATION BECOMES AVAILABLE TO THE MANUFACTURER AT A LATER DATE, AN ADDENDUM TO THIS FINAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

THE MANUFACTURER PREVIOUSLY REPORTED MDR 2518422-2022-81243-1 WITH INCORRECT INFORMATION IN SECTION B2 AS HOSPITALIZATION. AFTER REVIEW, IT WAS DETERMINED THAT THIS WAS INCORRECTLY SELECTED IN SECTION B2. NOTHING SUCH HAS OCCURED TO THE PATIENT. CORRECTIONS TO PREVIOUS MDR ARE MADE IN THIS REPORT AS FOLLOWS. SECTION B1 WAS UPDATED TO REFLECT PRODUCT PROBLEM. SECTION H1 AND H6 HAS BEEN UPDATED TO REFLECT MALFUNCTION.

Description of Event or Problem · 0

THE MANUFACTURER RECEIVED VOLUNTARY MEDWATCH (MW5105670) ALLEGING AN ISSUE RELATED TO A CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE. THE MANUFACTURER RECEIVED INFORMATION ALLEGING TO HAVE COUGH. THERE WAS NO REPORT OF SERIOUS OR PERMANENT PATIENT HARM OR INJURY. THE MANUFACTURER'S INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
271145 DREAMSTATION AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC DSX500T11C

Patients

Seq Age Sex Outcome Treatment
1 Unknown Disability| R| H